Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.
USAID Eliminate TB Project Health Programs Group Management Sciences for Health, Addis Ababa, Ethiopia.
BMC Infect Dis. 2024 May 17;24(1):499. doi: 10.1186/s12879-024-09403-z.
Screening for tuberculosis (TB) and providing TB preventive treatment (TPT) along with antiretroviral therapy is key components of human immune deficiency virus (HIV) care. The uptake of TPT during the coronavirus disease 2019 (COVID-19) period has not been adequately assessed in Addis Ababa City Administration. This study aimed at assessing TPT uptake status among People living with HIV (PLHIV) newly initiated on antiretroviral therapy during the COVID-19 period at all public hospitals of Addis Ababa City Administration, Ethiopia.
A retrospective data review was conducted from April-July 2022. Routine District Health Information System 2 database was reviewed for the period from April 2020-March 2022. Proportion and mean with standard deviation were computed. Logistic regression analysis was conducted to assess factors associated with TPT completion. A p-value of < 0.05 was considered statistically significant.
A total of 1,069 PLHIV, aged 18 years and above were newly initiated on antiretroviral therapy, and of these 1,059 (99.1%) underwent screening for TB symptoms. Nine hundred twelve (86.1%) were negative for TB symptoms. Overall, 78.8% (719) of cases who were negative for TB symptoms were initiated on TPT, and of these 70.5% and 22.8% were completed and discontinued TPT, respectively. Of 719 cases who were initiated on TPT, 334 (46.5%) and 385 (53.5%) were initiated on isoniazid plus rifapentine weekly for three months and Isoniazid preventive therapy daily for six months, respectively. PLHIV who were initiated on isoniazid plus rifapentine weekly for three months were more likely to complete TPT (adjusted odds ratio [AOR],1.68; 95% confidence interval [CI], 1.01, 2.79) compared to those who were initiated on Isoniazid preventive therapy daily for six months.
While the proportion of PLHIV screened for TB was high, TPT uptake was low and far below the national target of achieving 90% TPT coverage. Overall a considerable proportion of cases discontinued TPT in this study. Further strengthening of the programmatic management of latent TB infection among PLHIV is needed. Therefore, efforts should be made by the Addis Ababa City Administration Health Bureau authorities and program managers to strengthen the initiation and completion of TPT among PLHIV in public hospitals.
在人类免疫缺陷病毒（HIV）护理中，筛查结核病（TB）和提供结核预防治疗（TPT）以及抗逆转录病毒治疗是关键组成部分。在埃塞俄比亚的亚的斯亚贝巴市行政区，尚未充分评估在 2019 年冠状病毒病（COVID-19）期间接受 TPT 的情况。本研究旨在评估在此期间在亚的斯亚贝巴市行政区所有公立医院新开始接受抗逆转录病毒治疗的艾滋病毒感染者（PLHIV）接受 TPT 的情况。
回顾性数据审查于 2022 年 4 月至 7 月进行。从 2020 年 4 月至 2022 年 3 月期间，对常规区卫生信息系统 2 数据库进行了审查。计算了比例和平均值及标准差。进行了逻辑回归分析，以评估与 TPT 完成相关的因素。p 值<0.05 被认为具有统计学意义。
共有 1069 名年龄在 18 岁及以上的 PLHIV 新开始接受抗逆转录病毒治疗，其中 1059 名（99.1%）接受了结核病症状筛查。912 名（86.1%）无结核病症状。总的来说，902 名（86.1%）无结核病症状的病例接受了 TPT 治疗，其中 70.5%和 22.8%分别完成和停止了 TPT。在开始 TPT 的 719 例病例中，334 例（46.5%）和 385 例（53.5%）分别开始接受每周异烟肼加利福平治疗三个月和每天异烟肼预防治疗六个月。与开始每日异烟肼预防治疗六个月的患者相比，开始每周异烟肼加利福平治疗三个月的 PLHIV 更有可能完成 TPT（调整后的优势比 [AOR]，1.68；95%置信区间 [CI]，1.01，2.79）。
虽然筛查结核病的 PLHIV 比例很高，但 TPT 的接受率很低，远低于实现 90%TPT 覆盖率的国家目标。在这项研究中，相当一部分病例停止了 TPT。需要进一步加强 PLHIV 潜伏性结核病感染的方案管理。因此，亚的斯亚贝巴市行政区卫生局当局和方案管理人员应努力加强公立医疗机构 PLHIV 的 TPT 启动和完成。
